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Dermatology/Paronychia cellulitis

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Question
Sixty seven yr old 118pd female. Diagnosed with Paronychia with no formation of puss, just red inflammation and swollen Index finger. Was prescribed keflex  4xday and soak Epsom salt which I did diligently for almost 1 wk but no resolution. Then MD added Generic Bactrim DS for 7 days 2 x day and pricked for blood sent to lab. No puss. Culture came back negative. Finger never total resolved but MD said should be ok don't worry, no restrictions just finish Bactrim 3 pills left which I did. Now one week latter finger still somewhat swollen not resolving as expected but even seems worse today.  Is this type situation common? Concerns re infection not gone, not known pathogen, antibiotic resistance and side effects. Is this a common situation?  What is your opinion?  
Getting anxious about this whole thing. Thank you in advance so much.

Answer
Chronic paronychia Since most cases of chronic paronychia are caused by fungi, your doctor will treat the infection with antifungal medication that is applied to the skin, such as clotrimazole (Lotrimin, Mycelex) or ketoconazole (Nizoral). You may have to apply the medicine every day for several weeks. You also will be reminded to keep the skin clean and dry. Rarely, in severe cases, you will need to take antifungal drugs or steroids by mouth. You can also use topical iodine which kills everything including yeast and fungus.

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Michael S. Fisher, <B>Ph.D., M.D.</B>

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